Rhinoplasty Q & A

Q & A With Dr. Jack Kolenda About Rhinoplasty

Rhinoplasty, commonly known as a “nose job,” is a complex plastic surgery procedure that involves reshaping the nose. It’s a complex surgery, and it’s crucial to work with an experienced surgeon who is an expert in the procedure—and to understand the options and probable outcomes. Here are answers to some of the most frequently asked questions about rhinoplasty.

1.What is rhinoplasty?

Rhinoplasty is a cosmetic surgical procedure to reshape and resize the nose.

2.What is the difference between rhinoplasty and septoplasty?

Septoplasty refers to a surgery that addresses nasal breathing. For septoplasty, all the work is done internally and has no effect on the cosmetic appearance of the nose. Septoplasty and rhinoplasty procedures can be combined, and it is ideal if a person who is contemplating both operations does so; as the effects of the septoplasty may compromise what can be achieved if future rhinoplasty is to occur.

3.How much does it cost? Does OHIP or insurance cover it?

The cost of a rhinoplasty procedure can vary per clinic and is generally determined based on the surgeon’s qualifications and experience. OHIP or medical coverage is for functional issues only.

4.How do I choose a surgeon?

Rhinoplasty is the most complicated surgical procedure to perform. It is crucial to find a surgeon with extensive knowledge and experience. If you have a list of potential surgeons, it can help to have a few consultations. Your surgeon should make you feel comfortable and understand your desired end goal, but also provide you with realistic expectations to help you design a nose that is well-suited to you and your face.

5.What happens during rhinoplasty?

In most rhinoplasties, you will be administered general anesthesia. However, some surgeons perform rhinoplasties under sedation anaesthesia, where the client does not feel the pain but can have limited awareness. During surgery, your surgeon will make incisions to access the bones and cartilage. The surgeon will then add or remove bone and cartilage to change the form and function of your nose, if needed.

6.What’s the difference between an open and closed rhinoplasty?

In a closed rhinoplasty, incisions are placed inside the nose. In an open rhinoplasty, the doctor cuts immediately underneath the nose, known as the columella. This is the skin and cartilage bridge in between the nostrils and the skin can be elevated over the tip and bridge of the nose. Simply put, it is like opening the hood of a car to see the engine.

Some doctors say closed rhinoplasties heal faster than open. Others say the open technique provides more control during the operation, leading to more consistent results. It is important to know the difference between these two surgical techniques and ask your provider what is best for you.

7.What’s the recovery time?

Recovering from a rhinoplasty takes time and patience. Immediately following your surgery, expect visible swelling and bruising—which may include black eyes. A feeling of congestion and restless sleep is also common. About a week after the surgery, your cast and nasal packing is removed. At this point, you can expect to breathe and sleep better, and be able to blow your nose.

In most patients, bruising subsides after 10 days. The swelling will be visible immediately after the cast is removed. The swelling will continue to improve month after month until final results are achieved at one-year post-surgery.

Most surgeons recommend waiting at least a month before returning to vigorous activity and exercise. Often people will ask how soon after the surgery they can wear glasses. The nasal bridge will become stable at two weeks so you will be able to safely and comfortably wear glasses then.

8.Will I have visible scars?

If your surgery is done with the “closed” technique, then all incisions are inside the nose and no scars are created in your skin. If you have the “open” technique, then there will be a very small, unnoticeable scar in the skin of the columella. If the nostrils are made smaller then there will be small hidden scars in the alar crease.

9.Does rhinoplasty hurt?

Many patients find that a rhinoplasty is more annoying than painful from having to experience the changes in breathing and having to sleep upright—which is recommended to reduce the swelling. Pain medications are prescribed to every patient to help keep them comfortable.

10.Is there a non-surgical alternative to rhinoplasty?

Rhinoplasty is the only answer if you seek long-lasting results. However, dermal filler injections can be completed as a non-surgical alternative to correct minor issues. This non-surgical nose job typically lasts at least six months to a year. It is important to note that filler augmentation cannot make the nose smaller.

Dr. Jack Kolenda, MD, FRCSC is a certified member of the Royal College of Physicians and Surgeons of Canada and a member of the American Board of Otolaryngology. Considered to be one of the top facial plastic surgeons in Canada, his well-established practice at Verso Surgery Centre focuses on Head and Neck Surgery, Facial Plastic Surgery, Medical Cosmetic Aesthetics, and Robotic Hair Restoration.


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